How Humans Raised Children 1000 Years Ago - Dr Paul Turke

How might child rearing look different if parents were educated in evolutionary theory? Well, I think quite a few ways. Um, probably the biggest one and one of the big themes in my book is that we used to live embedded in kinship networks. Um so we had lots of different uh helpers, contributors uh helping us to raise our children. The you know there are situations now where one parent usually a mother gets stuck with three kids in a in a home and uh uh that's very different from how things used to work uh back in the day. And it puts a lot of stress on everybody uh children but parents parents also. Uh so that's a big thing. Um kids when they would go out to play and run around they would uh be in sort of mixed age groups. So they would have uh if you were a three-year-old you'd have a sevenyear-old there uh to to learn from and you might be helping a two-year-old. And uh so the the sort of the independent child stuff would be different. Uh so those are two of the big ways that uh we've lived in we live now sort of in a m mismatched environment. Mhm. What about what does that say about broken homes or unintacted homes increasing single parent stepparent? um what are the implications of that when it comes to child development? Yeah, I think it puts uh a lot of stress on on children. Um it also, you know, the human brain, the child's brain is very malleable, very uh very undeveloped when when baby first appears on the scene. And when we change the environment uh the early environment uh that children are reared under, we sort of miss I think some of the cues that lead to uh uh normal development. Now humans if anything, you know, we're we're flexible. We we can adapt to a lot of different things. So it's not uh uh the end of the world. But if we're but if we're trying to optimize, you know, we're we're sort of off the optimum if we're um under those sorts of stressful situations. And I think it that has implications for uh happiness and and healthiness and um you know just emotional well-being, that sort of thing. and and even things like ADHD potentially the more spectrumy things on the autism spectrum all of that can be affected I think by uh this mismatch uh environment stressful broken homes that stepparents like you say um so um I I don't know if you want to go into it but there there was a group of evolutionary psychologists of Martin Daly and Margot Wilson who did early work on uh uh stepparenting and um you know they found that uh uh stepparents tend to be I mean most stepparents are great you know of course they step in they help they're wonderful but there statistically there's more likelihood of of abuse or neglect coming from the stepparent you know it's the old Cinderella thing uh and so uh um you know the more our in our environment is altered from what we used to have where there were always three or four people. So if if grandma was a bad apple, you know, there were other people that step in. Um but if it's if it's just a broken home and just one one mom or one dad and uh you know that that can that can increase the the amount of abuse and things like that that that go on. Um, so, uh, that was very influential early work in evolutionary psychology. And some people got upset about it. Were they saying, "Oh my god, does because it's natural, does that mean it's okay for stepparents to abuse kids?" And, you know, of course, that that doesn't make sense. That's the naturalistic fallacy. And um, yeah. No, we it it it it's almost the opposite. It's the idea that, you know, hey, if you're going to be a steparent, uh, just be forewarned that there's some going to be emotional challenges for you and, uh, it could be a little bit harder than, you know, and that sort of thing. So, we would we would hope that would remedy the situation, not not excuse it. Yeah, it's uh, be extra vigilant if you're a stepparent. You know, this is going to be tough. raising kids is tough and one of the ways that the toughness of raising kids gets ameliorated is by them being your genetic progeny. So like they're crying again for the seventh night in a row, but it's my cry. So, but if it's just the person that you're in love with's progyny's cry, there's a lot less motivation to be there and you might get more frustrated so on and so forth. And yeah, I think it's a a 100x increase in child mortality when there's a one non-biological parent in the household. So some of some of the outcomes I mean the base rate for that's quite let's not saying that it's making a massive difference but it's a sufficiently uh significant difference that it's something everyone should be aware of. You mentioned there about grandparents uh what's the evolutionary role of grandparents or why does it matter for raising kids back then and sort of what's the implication for today? Yeah. Well, I mean, I think it's huge. Uh, grandparents, well, first first of all, when we we used to live about as long as the other apes, you know, up till about 6 million years ago. And the the the way we sort of extended our reproductive viability most likely, especially for grandmothers, uh, if if menopause was ancient as we think it was, it was by caring for children. Uh so reproducing indirectly, taking care of the kids we've already reproduced and helping them. And one of the big ways we help them is by taking care of uh their children. And so there's been this longunning history of uh uh gr grandparents and and babies and children and grandchildren uh interacting and helping one helping one another. And uh I think it's good for uh both both sets. Uh when I when I was younger doing field work, I was interested in the what the grandparents were doing and how they were helping and and that sort of thing. And uh as I got older and became a grandparent, I was I still was interested in the other stuff, but I became more interested in why we do it because it's hard work. You know, come home at the end of the day sometimes after there's been arguing and fighting. But um you know it it really makes my life uh happier and more fulfilled. And I think we sort of have an epidemic of unhappy grandparents at least in in the US and I think in other parts of the world too. And uh you know sitting on the beach having your uh pina colada or golfing or whatever can can be fine but uh you get a lot more satisfaction over the long run I think if you're useful if you're helping uh uh people. Um well I remember um David Bus saying oh no sorry Steve Stewart Williams at the start of uh the Apo understood the universe he's talking about what is it that we are um uh like maximizing machines or optimizing machines I can't remember what it is that he says and he comes in to land that we are grandchildren maximizing machines or we're grandchildren optimizing machines that it's not enough to just have a child it's enough to have a child and make sure that your child has a child and then we're kind of like ah Ah, okay. Like my my work here is done. Um, but yeah, you know, to kind of put it in context for the modern world, one of the first things that everybody does is fly the nest. You're 18, you're off to university, you're 22, you get your first full-time job, you move away to the big city, and you don't really think about your parents in that sort of a way. You're liberated, you're you're, you know, renegade doing it on your own. And then even in the modern world, uh, everybody has their own abode. very few people are living in pong generational cities, let alone piggenerational like houses or or neighborhoods. And then even with all of those incentives, all of the opportunity to travel the world, all of the different places and things that could distract you, how many people when kids come onto the horizon and someone gets pregnant, moves back to the city where one of the parents are, right? It is so it maybe not anywhere near as common as it would have been ancestrally, but to think you have all of this pull, all of these dynamics distracting you to go out and there's still something in the back of your mind that goes, I think we should be near uh Nana and Granddad. I I kind of get the sense that we should be back there. So, uh maybe I don't know, maybe evolution is still whispering in people's ears a little bit even I I I think it is. And and then when when they do it, they're They're they're very, you know, happy. I mean, it's just sort of a truism. If you talk to a grandmother or a grandfather and ask them, you know, what's it like hanging out get having the opportunity to hang out with your kids? Uh, it's the best thing best thing ever. You know, they and again, you know, there the nice thing about being a grandparent is you're not 247 either. you can sort of uh uh you can do some of the other things like you know golf or hang out on the beach or whatever but you have more flexibility but uh yeah there's this draw people people just sort of naturally realize that that that's that's the the way to go and and that's why I I'm concerned about some of our younger generation that you know they're they're good people, a lot of like the young eco warriors and so on, they I read online them saying things like, "Well, the last thing the world needs is more children." Um, well, you know, that you make that decision early and then it's hard to hard to reverse that, you know, and I think I think it comes back to bite a lot of them. Um, but I also think kids are important. I think kids are uh going to be the problem solvers. uh you know we have uh a lot of problems that the the world faces, the planet faces and so on. And it's it's not going to be um your dog. I mean, I I love dogs, don't get me wrong, but it's not going to be the dog who's going to figure out new ways to, you know, solve global warming problems or whatever. It's it's going to be it's going to be our children. So, uh um and and the pro the problem with it it is is you make that decision in your 30s and 40s and then you're 50 and you might start to say oops and then it's kind of late, you know. But um one one of the good things is that back natural selection never had to be more specific than it needed to be to solve the problem. So because we were embedded in these kinship networks and people people like sex and when babies came they tended to be pretty you know uh uh willing to care for them and love them and want to nurture them. That led naturally uh to reproductive success but none very few of us just walked around back in the place of scene saying I want to have children. I want to have children because we those other two things, you know, led to having children. And so I I don't think early on as young people we we think those things. So it's easy sort of to, you know, be led off track and and say, uh, yeah, I don't want to have kids and it's not a good thing to have kids for various reasons and whatever. And then suddenly think, uhoh, it's it's too late. maybe I should have should have uh uh you know gone gone in the other direction. So uh so I worry about some of the younger generation doing that. But oh, what I was starting to get at though is because natural selection is not all that specific is you you can probably make yourself happier and build a fulfilling life even after you've not had your own children and grandchildren just by helping because in you know help help we we feel good about helping. We feel good about being relevant. So I would encourage people out there to uh even if they don't have children to you know to maybe uh do something that's helpful for them and I think they'll feel happier happier for it. Maybe that's the pediatrician coming out in me. But okay, so uh one big uh mismatch um pgenerational uh alo parenting um and then the sort of inclusion of of grandparents. Is this in your opinion does this explain the grandmother hypothesis why it is that uh humans exist after they're able to continue reproducing? Specifically uh mothers or grandmothers. Yeah, I I I do I I think um I think there's reason to believe that menopause is pretty ancient that it that it started to happen right after the split from the other homoid apes. So basically selection stayed stronger for longer because we were doing things helpful uh increasing our reproductive viability later in life. But selection for some reason didn't push uh ovulatory function to later and later ages. And I think the reason is is because it was more adaptive to stop at a certain age because children were becoming you know more more helpless more altruial is is the word. And uh their their their period of dependency lasted a lot longer. And so, um, if you can if you as a a woman can have a child at 71, uh, the the potential chance, just to just to kind of break that down for people who might not be familiar with the grandmother hypothesis, uh, can you give a a a basic uh explanation of of what it is, like why that's the case. Yeah. Yeah. Yeah. Um, so women stopped reproducing directly in in their 40s because as children were becoming more and more needy uh and uh the the chances of them surviving and being successful if you died before they were 10 years old or so uh became very very very low. And so it became adaptive to stop and nurture the last child that you had maybe when you were 40 years old. And then um uh so we would we would live that that would keep natural selection stronger uh to later ages that that need to uh reproduce indirectly by helping children you already had produced uh that held off the ravages of old age. And so the whole thing just kept increasing so that eventually we live long enough to take care of our children's children. And so the grandmother hypothesis sort of explains why we live uh to later and later ages but also why we don't directly keep reproducing uh during that time. I suppose as well limited resources uh food uh not not only uh care but uh if you are able to contribute if you're able to be a net positive to the survival of not only your children but your children's children and maybe your friends children's children you know and you get that uh reciprocally in in return the alo parenting thing uh but you're not that much of a drain on resources uh old older people don't eat that much. Uh, you know, they they don't I guess they need care kind of uh eventually at some point, but I would imagine that that care wouldn't have been very protracted. The uh uh end of life stuff I imagine isn't that sophisticated ancestrally. Um. Right. Exactly. Yeah. I was listening to one of your podcast was Peter Aia and he talks about slow death and long death and uh you know the slow death wasn't wasn't there. You you were relatively fit and then and then something got you. So, you weren't a burden on everybody uh back back in the day like that. And and so even even for males, you know, you you brought up a good point. Um you you know, they might not be taking care of the children, rocking them to sleep and doing things like that quite as much as as grandma did. just just the male being around uh held together helped to hold together kinship networks and helped to transmit knowledge that had been accumulated, you know, like where the where the watering hole doesn't go dry when we're hunting for such and such and so on. Males, males could be contributors also. And if they weren't busy getting beat up by younger males because they were competing for you know the the females uh they you sort of dropping out of that game and being helpful in other ways probably was uh uh adaptive for them too and a route to indirect reproduction. Okay. So, uh, grandparents, pgenerational raising, alopparenting, stuff like that. Uh, mixed age play, uh, younger boys and girls learning from older boys and girls, rough housing, understanding how status hierarchies work, getting to expedite learning because the older kids know more and they get to teach the younger kids as opposed to everybody kind of moving and discovering at the same age. Um, what else? How else is modern parenting out of sync with how we evolved to raise children? And what are some of the least aligned child rearing strategies of the modern world in your opinion? Uh well I think uh that covers it uh in in terms of the sort of the sociology of it but we're we're out of alignment with uh in terms of in infectious disease exposures and things like that with you know with our daycare centers and so on stuff like that. kids uh experience different degrees of of illness uh uh different types of germs, different uh uh immune system developmental trajectories and so on. Um, and and again, kind of I touched on this a few minutes ago, but just uh I think it predisposes sometimes to some of the, you know, not super severe mental illnesses, which I think come more from, you know, genetic and broken brain type, what I call break broken brain type phenomena, but just some of some alter some of the altered input puts from not carrying our children around all day long and or having aloe parents carry them around and talking to them all day th so those sort of early inputs are are quite altered by the uh social structure that we now that we now live in. Should we see teenage angst or anxiety or ADHD as adaptations instead of diseases then? Uh up to up to a point uh especially anxiety. I mean we you can't live without anxiety. If I could give kids a pill to make them never feel anxious, then that probably wouldn't be good for them. I mean, we, you know, if you if you're walking down a path in the woods and you see mama grizzly bear with her cubs and you don't feel a little bit anxious about taking the next step forward, that's probably not very adaptive. M so so we need to feel anxiety but um but we need to learn how to deal with it because there there are all kinds of anxiety producing situations that we have now that we didn't used to have especially for teenagers. you know, they're they're they're they're living in a virtual world a lot of the time and they're uh you know, they're thrown into middle schools with, you know, 200 other kids their same age without support of of kin all day long and and that and that sort of thing. And that that creates anxiety situations that we we don't need to eliminate, per se. we need to learn to deal with them. How is modern child rearing and uh the environment that kids are brought up in potentially predisposing the anxiety, the ADHD, the teenage angst in a way that would have not occurred ancestrally? What what are some of the contributing elements to that? Yeah. Well, I I think that it it is, you know, having very supportive uh kin who who love you all around that can sort of take you aside and say, "All right, that's that's not that awful of a situation and explain things to you." But I'm always struck by and it's not always a bad thing, but I'm struck by the wide range of options that our teenagers face. Now when I was doing field work on Ephook, which is not a huntergather society, it was a horicultural society, but it was pretty primitive, pretty pretty isolated in the in a technological sense. And those kids growing up knew what they were going to do. You were going to be you were going to fish, you were going to build canoes, you were going to uh, you know, weave mats to build roofs for the house, and you were going to take care of kids. And, you know, that that was about it. there weren't just this huge range of options. And and again, I I I think it's great that we have this huge range of options. You know, you and I wouldn't be able to do what we do if we were living in that situation. But it also presents so much uncertainty to these kids. They sometimes just don't know where to go. And then they re they retreat into a virtual world and uh they they don't know who to you know they don't have people around all day that they can talk to about it. They don't have older kids who have been through it necessarily to model after and and so on. So it's it's it's pretty disruptive. Um ADHD is I think is a little different from anxiety. Um, I I I think what I tell kids, and I may not be completely capturing the whole uh spectrum of it, but I tell kids, you know, that I I was 5'6 back in the day, and I've since shrunk. And if the whole world were a basketball court, I wouldn't be very well adapted to it. And now in school, when we send kids to school, we funnel them all through, you know, through the same funnel. And so we we kids who are, you know, a little bit uh shy, quiet, they're not active learn active learners, they pay they're good at paying attention, that kind of thing. They get overvalued. But the kid who's a more active learner who would rather run around outside and learn things that way. They they're not quite as able to. Um but back in the day um in the place scene and on in existing traditional societies there there's room for kids to do uh you know if if you're an active learner well you go out hunting. If you're left active learner you you you make the arrowheads. You know there's all kinds of roles for for kids that they could fill. What are your thoughts on daycare? On daycare? Yeah. Um, well, I think well-run daycares can be good in the sense that they they can mimic uh the alo parental situation where you have multiple committed individuals and you know and and especially if they're like uh I think like in the monastery settings they'll have more of the like you know three year olds with four year olds with fivey olds and so on. I think those those can have certain advantages, but what I don't like about daycarees is that well, first of all, many of them are just overcrowded. You've got, you know, the the the caretakers are are overwhelmed and they can't give the kids as much attention as they want. But, uh, it it's the it's the infection that you there. I mean, we I we live up north here in Michigan where it's cold 6 months out of the year and the virus is hit and you know, parents, you know, they have their kids in daycare and and three days out of five they've got to keep them home because they have a fever or something and all of that. So there there's a lot of uh uh infection uh risk that you have to deal with that you wouldn't have had to deal with uh you know again during during ancestral times. So it seems to me like one of the big changes is a a level of attentiveness from uh primary caregivers to babies and then children. It seems to me like you're suggesting it would be rare that children would be put down on the ground sort of left left all that much. Is is that an accurate assessment? Oh, it it's abs it's absolutely true. Um there was just no safe place to put a baby other than in a caretaker's arms, you know, during the place scene and before that. So, have you got any idea just thinking on that? Is there any data around the difference in uh skin-to-skin contact time from ancestral times to the modern world? I think we know we're probably going to be talking what 10% maybe 20%. Yeah, I don't know of any data. It'd be an excellent study for somebody to do and maybe somebody has. If they have I I I don't know, but I I think it's way down. Um and things like um you know plasphille the flattening of the head kid when kids are held you're always switching arm to arm different positions uh and same thing when you know with co-sleeping you know doing it safely kids kids parents parents would you know mom would sort of curl around baby they'd be in different positions and so on we can just see now that like six I think one out Six kids in the US gets these head flattening conditions called plagiiophily and it's from not being carried. It's from being flat on your back. Oh wow. It's it's literally an imprint of the floor that you were laid on for so long when when your cranium was still malleable. Exactly. And then the related condition is toolus where you get this neck tilt and then you got to send them for physical therapy to try to uh straighten it out. So, so those are, you know, easily seen things, things you can notice. But I also wonder if, you know, we have all these sensory issues that come up in kids now, sensory integration disorders and so on that tend to, you know, they can if they're extreme, they can put them on the autism spectrum and so on. And I'm just wondering if you know you get different sounds, sights, smells, orientations, and so on that when you're being carried around and talked to constantly as opposed to stuck in a corner and some kind of little device or carrier, if that if that doesn't impact the development of of uh you know, our our our sensory uh machinery up there in the brain. Well, think about all of the talk of uh attachment styles and attachment disorders, anxious attachment, avoidant, dismissive. Uh I don't know. I mean, even the studies where baby is left in room, toys are strewn around, mom leaves room, mom comes back in, baby calms back down eventually. How far does baby go away from mom? Uh I'd be fascinated to see the ancestral equivalent of that. you know, how how amazing it would be for us to be able to run some of these uh split test uh uh experiments. Well, so you mentioned um co-sleeping. How where would babies have slept ancestrally? How would they have slept? What's the typical sleeping environment like? Give us a breakdown. Co-sleeping was the rule. I mean, they didn't have soft beds and things like that and heavy comforters. it mostly would have been done on mats or on firmer surfaces and it would be generally mom would curl around the baby. The the term that that's thrown out there now is it's called breast sleeping. There've been videotapings of how how how moms just sort of instinctively curl around baby and then you know pat pat her on the head while they're not even awake and baby has the breast available and can go from side to side. So, in my view, you know, I mean, that's the way we all we always slept. There were there were no separate rooms or or beds or anything like that. So, it's not co-sleeping that's dangerous. It's sleeping uh co-sleeping dangerously that's dangerous. You know, if you if you're trying to do it on a couch or something where baby's head can get wedged in the pillows and that, you know, or the cushion, you know, that can be dangerous. But the I think Japan is is is a good case in point. Co-sleeping is generally the rule there. Uh and and they have half the SIDS deaths and half the infant mortality rate that that we do. So it's not co-sleeping per se. I think it's co-sleeping unsafeely that is is is the problem. And I think co-sleeping has some advantages in terms of development. And it's uh you know this gets me in trouble with or at odds with the American Academy of Pediatrics and and I understand I mean they're speaking to a national population and they have to be talking to people who you know maybe they live in an impoverished situation where they don't have safe bedding or maybe maybe dad's an alcoholic and if he hops in bed that does put baby at risk and you know all these things. So, so I sort of understand their their position, but just coming out as they do hard stance against any co-sleeping I I disagree with. And a lot of the European countries are coming around to that view, too, that it's okay to do it as long as you're being careful. Talk to me about the transport response in infants. The what? Transport response. I I don't know what that is. when babies uh they seem like they fall asleep more easily when they're being walked whilst carried. Is that not Yeah, that was that was uh Rob Henderson and me were talking about it earlier on that uh if you want to put a baby to sleep, you put them in one of those, I guess, rocking, you know, it's like a automaton thing and you're thinking, okay, so what are you trying to simulate there? You're trying to simulate being carried, right? Carried. Exactly. Yeah. Yeah. I know. I I just spent uh a week off with uh the grandchildren, one of them six months, and I just kept saying to myself, why won't you let me sit down, you know, walking, but they they just don't they they want they want they want you up, you know, and uh what's the what's the adaptive explanation for that? Why would that be the case? Is that safer? Baby, if baby's being carried and moved, it's less likely to be eaten. I I think probably it has something to do with that. I mean certainly being carried and being in close proximity. I think babies feel anxious when naturally just feel anxious when they when they don't have that proximity. I'm not quite as sure about uh you know why why they want us to be expending the maximum amount of calories carrying them about and rocking and and bouncing. But uh um you know what what you just hypothesized there or speculated is that they that's sending them signals that they're being held, that they're being cared for. You know that uh that could it could be something as straightforward as that. They're a a meal on wheels as opposed to a TV dinner. And uh it's it's harder to catch the meal on wheels, especially if the wheels are mom or dad. Yeah. Okay. So, why um what about some explanations for why toddlers might uh wake up at night or throw food or act out? Why might those be uh smart behaviors in some way? Yeah. Well, to toddlers toddlers wake up at night because they wanna they want to check in with, you know, mom and dad. I I I think and uh they you know they don't have as as much incentive to you know they don't have to get up and do anything in the morning and and so they they're they're they're free to to satisfy their their whims that that way. Um as far as throwing food and uh tantrums if they don't get their way uh um well there are a couple things th throwing food especially uh vegetables and new foods. I I think that uh uh toddlers once once you're mobile, you have this natural aversion to uh just putting anything in your mouth. Unlike when you're, you know, four months old, you'll put anything in your mouth. But as you get more mobile, uh if you're, you know, just crawling about or toddling about the campsite, if you're willing to put everything in your mouth, that's probably not going to be good for you. So, you hand you hand a a six-month-old a stock of broccoli, they'll they'll eat it. You hand a two-year-old a stock of broccoli, they're likely to throw it to the floor. And I think that makes some some good adaptive uh sense. Um, as far as uh tantrums go, um, and just being very very needy, I I I think I I I don't really know what the adaptive explanation is for that, but I do, you know, think that they just cognitively um, uh, they're not very empathetic yet. They can't really put themselves in another individual's position and say, "Well, mom's busy right now. she can't carry me around even though I want to be carried around and you know and so they they they just want what they want and you know at one moment they might want to give you a kiss and the next moment they want to hit you over the head or something. Uh it's just because they they I I don't think they've got it all all figured out yet. You know, they they're they're still learning how to be social. I mean they're they're they're much better at it than say a chimpanzeee would be at a similar age but uh uh it's a long learning process in humans learning I mean we're we're the hypers social species right that's that's how we've prevailed is we we know how to get along in groups and uh we reciprocate with one another and uh and it's a long lesson for kids to learn sharing you know it's it's not an easy concept uh uh you but they it takes a long time to learn it and that's why a lot of aloe parents a lot of help and taking a long time to do it uh is is uh uh very important that's why those things have evolved I think as an only child you are speaking my language here uh struggling to learn to share etc um what do we know about breastfeeding uh we know it's the the best way to go and We uh it has numerous advantages for baby and and mother. Um you know it helps establish a proper microbiome. It helps uh protect you early on in life when your own immune system is still getting up and running. Uh protects you especially from diarrhea illnesses which used to kill a lot of babies back in you know uh uh in traditional societies. Um, there's some evidence. I I don't know how solid it is, but there's some papers that I've read suggesting you get four to five extra IQ points uh if you're breastfed for a for a long period of time versus just in formula. There's some evidence that the microbiome interaction with the immune system and the nervous system uh can uh help reduce risks of developing uh mental angst problems, depression and so on uh later later in life. Uh and then of course for mom moms uh reduce their risk of of breast cancer from breastfeeding and Yeah. Yeah. Wow. Wow. Yeah. And there's a really cool study. I I it it seems to be pretty empirically sound. It was very surprising to me. It's in evolutionary medicine and public health from a couple years ago showing that um uh moms who breastfeed their babies have a lower incidence of uh developing early dementia. Oh my god. How much is that? There may be some correlate there. I was going to say it could be a selection effect there. Yeah. Right. Yeah. So I don't know. But yeah, let multiple multiple benefits from it. And unfortunately, you know, we don't grow up with it. We uh uh it it it's it very smart people. I have some very smart parents in my practice and uh you know they're they're surprised when I tell them babies are designed to breastfeed for a couple of years and they don't know about breastfeeding and they come in from the hospital even if they've talked to a lactation consultant with their spreadsheets and so on. Baby's done this, baby's had so many poops and so many voids and blah blah blah and they're all uptight and milk's not coming in yet and they're start somebody's telling them they have to supplement and it all just interferes with breastfeeding. You have to relax. It just happens. You just it you know there's there's no breastfeeding failure in traditional societies or it's very very rare um because everybody sees it happen. They know how to do it. Uh and um but we have I I think it's less than 50% of US babies are still breastfeeding at at 6 months. Um, and uh, a lot of them don't even get that far into it because they worry about, you know, the initial weight loss or they worry about the jaundice that develops when you're getting a little bit dehydrated and, uh, you know, breast milk's not there yet and it's not washing out Billy Rubin and so on and and they start introducing formula and then baby says, "Oh, well, this is easier." and learn to prefer the bottle over over the breast. And uh so, you know, more often than you might think, both baby and mom end up giving Oh, wow. for them. Bo both parties have been weaned off of breastfeeding. Yeah. Right. So, yeah, that's interesting. What about uh C-sections? Yeah. Yeah, I mean I think uh you know C-sections obviously can be life- saving and are necessary in in some circumstances, but uh that I I just think that there some in some birthing centers there's they're just a little bit too cavalier about it. You know, mom's got a something coming up or the doctor's got a vacation. You know, it's just ah, you know, you're at 40 weeks now. Let's not let it go too long. Let's just do a C-section. That kind of thing. and uh or let's induce. So, same sort of thing. So, mom and baby have evolved a really good communication system for when baby is supposed to come. And we're not always really good at estimating what the exact conception date is. We know that because, you know, some babies are are are conceived now uh through artificial insemination and and we know then when that are conceived and we know that we're a little bit off when we're estimating using ultrasounds and when mom thinks her last period was and so on. So, so I I think they're overdone basically is the short short answer. They're they're lifesaving, wonderful interventions if done appropriately and much more sparingly than they are done now. Same with inductions. I I just don't love to hear, "Ah, you're you're 41 weeks and uh everything looks good, but uh maybe we should just induce you right now." Well, well, if everything looks good, I I always want to wait a few more days, you know? So, um, have you got a have you got a perspective on uh epidurals? Is there any insight there? Uh, I I'm not a real expert in that, but what I what I've been told by by moms and people that have them is it can interfere a little bit with pushing uh and getting getting the baby out. And so then that increase your risk of some uh doctor saying, "Oh, we better we better do a C-section here." that that kind of thing. Is there such a thing as a part epidural? Can you reduce down sensitivity by 50% or something like that? Do you know if they can tolerate it? You know, that's a good question. I I don't I don't know the answer to that. You would think that would be a good a good idea. I mean, it's easy for me to say, you know, don't don't do, you know, don't do epidurals, but um I mean, my my daughter and daughter-in-law were able to uh do it. And yeah, I guess they're pretty tough, but probably no tougher than the average. So, um, do C-sections interrupt lactation? I think so, because again, there's this there's this fine-tuned timing, uh, mechanism between when baby should come and when nursing should start. But also, mom's sore. I mean, it it's it's a surgery, and mom doesn't feel quite as good, and it's just not it's it's just harder for uh mom to get things going and be uh quite as uh committed and diligent to it when you're recovering from a surgery. I mean, I I could see, you know, that if I if I had to do some type of child care thing, obviously not breastfeeding, but I had just had a hernia surgery or something, I might be less reluctant to carry out my duties uh in that situation. So, I I think it probably does interfere some. I imagine that you have some concerns about surrogacy in that case then. Yeah. Yeah. um that I I I haven't experienced too many people who who've done it and I haven't run into any problems, but yeah, there there certainly can can be uh uh you know, it's a sort of a mismatched kind of thing. It's a not very novel sort of thing. So, we would expect there could be some problems there that uh crop up. Child birth, child rearing in the modern world certainly seems to have become very medicalized. Uh I wonder whether this overmedicalization could contribute to fertility decline in some way. Yeah, I I think so. Uh like I like I said, people come in with their spreadsheets and I have to tell them, forget about counting the number of dirty diapers and all all of those things. And uh people, you know, they they come in with Yeah. They've had C-sections. They've had they it's been overmedicalized and and it's it's uh uh it's just a much more stressful kind of thing uh than it is most likely in in a more natural setting. Uh I I think midwives often get people to relax. There's also a you know a home birth trend which you know I mean I I I see the reasons for it. Um, and when it works, it works. But it's also more risky, you know, uh, if something because things do go wrong in modern medicine. Uh, you know, like like again like your pre previous podcast with Peter Aia, we're good at uh fast fast deaths. We're good at avoiding those. So if something goes wrong, you want to be there. you want an obstatrician there who has a scalpel on hand if you need it. Um, yeah. So, so anyway, yeah. What have you come to believe about the current demographic transition, these declining birth rates that we're seeing? Yeah. Well, that that's sort of what my early interest was as a graduate student when I went off I I went to Ken State and worked with an anthropologist named Napoleon Shagnan. Um and uh he was in very much into uh uh ev evolution. Uh he was a cultural anthropologist who was becoming an evolutionary anthropologist. Then I followed him at Northwestern my second year and I had to figure out something to do. So I would go into the library and I got interested in demographic transition and there was not a really good explanation in my mind for why people in modern settings had decided all of a sudden you know they switched from we want to have as many babies as we can to we want to have just a couple or in some cases cases none. And the prevailing ideas out there, the prevailing theory was coming from uh economists and uh economic-minded demographers. And and their thought was well in traditional settings um after you pay this little upfront cost, kids become assets. They make you they make you wealthy basically and especially they care take care of you and things like that. And so there's no reason to limit reproduction in traditional settings. But um because they lived in modern settings and they probably had kids. They knew kids were expensive in in modern settings. And so they were arguing that we would limit the consumption of uh children expensive goods just as likely we would limit the consumption of all other expensive goods. But that didn't make sense to me from an evolutionary point of view. First, I didn't trust their data because they would go into these traditional societies and ask hunter gatherers, why do you want to have so many children? And that would be like asking, you know, why do you why do you breathe? Um, and and so I think I thought they probably teased out the answer they wanted, but you know, I have no way of knowing that. So, but what really troubled me was it didn't make sense from an evolutionary point of view that we had kids in order to eventually economically exploit them. Um, again going back to this idea that we had lifespans, maximum lifespans as long as as the other apes and then they gradually uh increased and doubled because we were uh doing things useful for our children. that that sort of idea didn't jive with the idea that you know once once they became 20 or 30 and we were 50 or 60 that you know we were just going to kick back and let them take care of us. Uh I always felt it was going to be the other way around and that's my early work contributed to the grandmother hypothesis and as it contributed to what we now consider to be the right explanation for why lifespans doubled. Um but uh this notion that uh wealth flows switched uh as modernization occurred and that's what made us not want children. Didn't make full sense to me. Now it does make sense that children of course became more expensive uh as as we left traditional settings and stuff. Um but they were always expensive. uh they were it all they they they never really did gave us more than we gave them except in terms of life satisfaction maybe. But uh so that that my explanation is is just that that we don't have kinship networks anymore uh that help uh spread out the costs of rearing children. Costs get concentrated on mom and dad. Mom and dad say you know this is hard work. We love these kids but we're only going to have one and we're only going to have two. And some people look around and say, "Oh, my friends over there are struggling. I'm not having any." So, I I think I think it has a lot to do with the demise of extended kinship networks and that help in the concentration of of uh care responsibilities on the on the decision makers. My uh I I've spent a lot of time thinking about this, much to the internet's uh distaste. Um but one thing that I don't think gets talked about sufficiently is the sort of mimemetic desire to have children to that oh wow my nextdoor neighbor they just had kids and or my sister just had her first boy and she seems really happy and that's a good maybe maybe I should think about that you know fewer children beget fewer children beget fewer people seeing children etc etc and um yeah the it's the vicious other side of the blade of being a hypersocial species as you said or ultra-ocial species. So moving on to you know we've talked a lot about sort of development child rearing the more sort of psychological and social side of stuff. If we get into the more medical uh elements of the pediatrics what are some what are some examples of medical missteps that could have been avoided if if we'd had some evolutionary thinking? Well, the the big one that that I worked on has to do with uh uh food allergies, childhood food allergies. um back in the '9s and it was officially codified by the uh uh American uh uh pediatric society in 2000 or 2001 I think it was that you delay delay delay when it comes to the introduction of the eight or nine most allergenic foods. And I mean first of all that evolution aside that just never made sense from an imological point of view. It just I don't know how they came up with that idea because once the immune system is able to cause destruction which starts in uterero and is present in a big way even shortly after birth you have to have proper tolerance mechanisms. It's not like you can wait uh till you're three years old to learn not to attack your own liver. Uh so why they thought waiting till you're three years old to introduce peanuts, you know, is really really beyond me. But the the evolutionary angle there that if they had been uh more attuned to how we lived, you know, in during the plene and and before that, we were immobile pretty much as a species. We didn't, you know, we we grew up in uh and died in the same ecosystem basically uh generation after generation. So what that meant was that while while mom was while you were inside mom and she was eating, you were getting exposed to food antigens. When you were she was breastfeeding you, you were getting exposed to food antigens. When you first started eating foods yourself, you were getting exposed to food antigens. And those food antigens were the very same ones that you were going to get exposed to for the rest of your your life. Um, and so, uh, they they they eventually learned, not through thinking about it theoretically in any way, but just by going, "Oh my goodness, food allergies are soaring." And, "Oh, look, they're not allergic to peanuts in Israel." Because they uh they feed children early on. They call them bombas, which are peanut butter containing uh uh biscuits. And so people started looking, well, maybe maybe we made a mistake here. Maybe we should introduce things early. And so uh they eventually did some studies and found out that that was true. But but if you thought about the way people always ate, you would be introduced to all the foods you would ever eat, all the all the allergens, all the antigens that you would ever encounter early on, and your immune system would learn to tolerate them. And uh so it never made sense to say, let's not let's not introduce things until you're you're you're older. So I think evolution-mindedness could have uh helped us to avoid uh uh that that problem. Um you know but I I mean I think I think there are others I think uh um ev evolution mindedness can help us to understand um what's a healthy diet. It can contribute to that. I mean, I I know from listening to you, you're you're you're interested uh uh in in that. Um it it turns out there there's a really cool study that was done uh with fruit flies by uh Michael Rose and his group uh uh Grant Rottled was a a grad student or a or a fellow who worked with him. And uh what what that what they did was they they they changed up the diet that the fruit flies had evolved to eat. They they had been eating for thousands of generations. They had been eating apple rot and then they brought them from uh that area which I think was on the east coast to Michael Rose's lab in UC Irvine and they didn't have rotten apples I guess so they fed them bananas doused in high fructose corn syrup and what they found was that after about 40 generations flies had adapted to that new diet to accommodate it really well uh while they were young, but even after a hundred generations, they hadn't adapted to accommodate that new diet what they were old. And that the the most parsimmonious explanation for that is that number one, selection is most powerful early in life. And number two, most genes have their effects combi confined to certain ages. So that if a mutation comes along that allows a uh a young fly to better digest a banana or if a mutation comes along that allows an old fly to better digested the banana, potent selection would accumulate for the young fly. Weak selection would not accumulate for the old fly. Is this why kids tolerate modern diets better than grandparents do? Exactly. Exactly. That's right. So beyond a certain age, you know, maybe 50 or so, uh maybe earlier, uh you should lay off the pancakes and donuts like that. That I mean, no, nobody should be eating a too much of that stuff, but you can certainly kids can do it. They can tolerate it much they can tolerate a grainheavy diet much better than say somebody my age can. So interesting because of that. Yeah. Yeah. you can apply that also that line of reasoning to uh infectious disease and I I did that in an article uh shortly after the pandemic got going. um crowd diseases, you know, came on board once we started settling down and living in crowds, uh moving indoors and so on, things like, you know, influenza and tuberculosis and, uh, uh, all those sorts of illnesses. And so uh as long as those diseases had certain commonalities like they relied on crowding and you know maybe aerosol breathing in aerosolized virus that kind of thing. Young immune systems should evolve more quickly to be able to adapt to those crowd diseases than uh old immune systems uh would. And um I I I there there's an evolutionary biologist that I've talked to who works with fruit flies who's interested in maybe trying to test test that idea. But um it it's a little more complicated with immunology than it is or with infection than it is with diet because we we have an adapt a very a potent adaptation uh immunologically that helps us when when we get a little bit older to to fight diseases and that's immune system memory. So very very young children often don't do as well within. Oh, of course. Because because they haven't acquired memory yet. You've accumulated all of the different blueprints of all of the different pathogens. Exa Exactly. But when you're talking about a brand new virus that's just jumped into uh the the population, no one has any memory doesn't count anymore. And then you should expect the young to have to if again there have to be commonalities. And there are four other corona viruses out there that passed through over the last 10,000 years. You would expect young people to have evolved adaptations to deal with those infections to a better extent than old people just as you would expect it for for diet. What about uh obesity in kids? Are there some uh evolutionary insights that you've come to believe with regards to that? Yeah, I I mean obviously it's just a terrible problem in our society. Uh uh yeah, like you said, it can it can start early and I mean it it I think largely comes from a mismatch. uh we used to have to work harder for our our foods and uh exert ourselves and uh and uh calorie dense foods were not as available. So we developed a taste for those and uh now that we don't have to work hard for to get the calories and we still have the taste for them. many people uh overdo it and they get their kids on that wagon uh quickly too where they're over consuming. And and then there's also just foods that nobody's had time to adapt to. this stuff in the center aisle of the grocery store, you know, the the trans fat laden things and all that that uh uh people soda pops and those kinds of things that people bring bring into their house. And so it it's a it's a daunting problem though. You can explain it to people. It's easy to get it's easy to understand that that mismatch. Um, but getting people to a, you know, be more active and, uh, avoid some of those some of those foods is is just a hard thing. I I, you know, I I dread it when I've got a a 10year-old who can't hop up onto the exam table. He already weighs 130 lbs and, you know, his parent sits down on the bench in the room and, you know, they're they weigh 300 lb. I mean, what what can I do? You know, I I I if I could take the kid home with me, you know, maybe I'd have a chance, but um it's just it's a really really hard problem uh to solve. But, um I I think it's just so so so such an important thing. I mean, especially our I mean, it's a problem in kids, but it's especially a problem in uh you know, as people get older. And um you know I I don't know what the number is but so many of our healthc care dollars get spent keeping people who've abused themselves uh you know for five six decades alive or you know trying to keep them partially alive at least and I mean I think most of our healthcare dollars get spent trying to keep somebody alive for the last three months of their li lives and that kind of thing. Is that right? I I think so. And uh uh if if it's not that I'm against helping people when they're older, but if if people would help themselves when they were younger and avoid some of these problems, all those healthc care dollars could be shifted uh to to young people and, you know, daycarees could be better and the then the mom stuck at home with three kids and no help. I mean, we could we could reallocate a lot of these things as a society if if people were just more responsible, but it's a tough problem, isn't it? I mean, yeah. It's not it's not just responsibility, right? It's hyperormal stimuli, calorie dense foods. We're not adapting for the salty, sweety. Absolutely. Fluffy, crunchy, you know, all of the all of the design. Uh so, it's Yep. We're up against all all of that and trying to get people to change. When it comes to medication, do you think are we maybe overusing medication uh in some ways for issues that might be biologically meaningful? Are we stepping into important processes that wouldn't have uh obviously been intervened with ancestrally? I mean, I think so. Uh, you know, I think antibiotics are wonderful inventions and life- saving, but they're certainly overused. Uh um and so that leads to the evolution of resistance and stuff. But the big category that I think is overused are this psychotropic medications, the you know putting putting teenagers on multiple anti-depressants and uh ADHD medicines and and so on. I I'm always happier to start with, you know, changing behaviors, modifying behaviors, start start with some counseling, start with some explanation, explaining to kids that it's it's natural and okay to feel anxious. Have you heard about the smoke detector principle? Of course. Yeah. That it's better to think there's a fire and there not be one than it is for there to be a fire and you not go off. Right. Right. So anxiety sort of operates that way. We get anxious and there's just so many things out there now to get anxious over. We have to learn to deal with it rather than take a pill to try to eliminate it. So I think there's a lot of overuse. And of course the SSRI uh that are used so commonly don't probably work as well as sustained exercise does over the long run. and uh you know but it's but it it's it's a lot easier to take a pill you know and people people often choose the easier way and there's a lot of pressure you know from the television and other media telling you take this anti-depressant and if that doesn't work maybe another one will make you happier so I think yeah I think it it's overused and I think having an evolutionary perspective can uh you know which includes something like the the smoke detector principle can help us to sort of uh pull back on on some of those things. And of course, these old people we talked about who are unhappy because they aren't taking care of their grandkids and they're on uh their SSRIs, well move closer to your grandkids. I I think that that'll work better. I would love someone to do a study uh you know uh pay for older people to move closer to their grandkids and give the other group uh SSRIs and see which which which one's happier. Yeah, it's uh it's really interesting I think considering how modern interventions that are well-meaning and and and help and and are needed in many context. I think a lot of the time it's the overprescription in the same way as it's not bad that we have cheesecake. I'm really really grateful for the inventor of cheesecake and for the earl of sandwich and his invention of the sandwich. Um but it's the overlication of uh these technologies and these foods that cause the issue. What would um I'm interested what would an NICU look like if it respected evolutionary design, do you think? Um well, you would you would allow uh parents, mothers to be in contact uh with their with their babies more and there there's there's they're doing that to some extent. You would be uh you know, you would be introducing breast milk as early early as you can. uh you would be I mean I saw I don't know how common it is but when I was a resident and in the in the NICU you know I saw babies who were induced or or made to come early who then had breathing difficulties and ended up in the ICU and on ECMO of all things because uh of you know kind of stupid errors like that. Uh, and so I I think um just just trying to uh being less cavalier about in inductions and C-sections would would help change the uh the complexion of of of NICU, but just allowing more parental contact. You know, they they they have and and there I think there's movement towards that. there's good information that they're trying to uh the problem is it it comes slower than I would expect because they they have to wait for a study uh to show it over and over again before they they uh you know they before they'll intervene in a way that's and that makes sense if it's dangerous intervention but if it's an intervention like let mom hold her baby more it doesn't seem like it's that dangerous to me we might not have And it might make sense from an evolutionary perspective, we might not have to wait for six multic-enter studies to be done in order to conclude that that's a good idea. Um so again, when it's a d a dangerous intervent potentially dangerous intervention, you want to have all those multic-enter studies done. But um uh doctors in in my opinion, you know, for good reasons are a little bit leerary of theory. Uh, nobody wants their doctor dreaming up a treatment for them in the shower the morning before. That's just, you know, kind of a wild speculation. Um, evidence is a good thing, but it can be it can be overdone, too. Doctors just, you know, medical students are just they're just not taught uh theory the same way graduate students are in other other scientific disciplines. And of course, I'm partial to evolutionary theory and I really wish that um you know, it made its way into the licensing exams and it made it into the premed programs and all that. I I was thinking about when I got into medical school, I had already had a PhD and I was teaching at University of Michigan and they let me in, which was great, but uh they said I had to go take a an organic chemistry course. So, I went to the local community college and and and took that and uh uh I've never really had to know any organic chemistry in anything I've ever done as a pediatrician. But uh if rather than that uh or in at least in addition to that, I'd love to see uh premed programs include evolutionary biology courses. And I'd love to see continuing metal medical education include more evolutionary biology. And I'd really love to see more evolutionary biology undergraduates decide to go to medical school. That would be that would be a real boon to the uh discipline. I'm all for it. I'm I'm super all for it. I think uh all parents need to read a in fact all single people need to read a behavioral genetics book as well if you're if you're intending on having kids at some point. Uh I think all of the uh dating advice in the world and all of the child rearing books in the world could be replaced with blueprint by Robert Plowman maybe. Look, if you if you if you want to have a family at some point, it is made up of the raw materials of the person that you make them with, and it's the single most important decision in a child's happiness. You you can't out educate bad genetics. Uh bad in, you know what I mean? Like difficult difficult genetic sub-optimal in in in your choice. So, you mentioned that um evolutionary theory, you're a fan, I'm a fan. Um what are the risks and are there risks in misapplying evolutionary theory to social or medical contexts? Um yeah, if it's badly applied, I mean there there's this whole it's been a ways back now of you know of social Darwinism and so on where uh you so people can misunderstand and think that it's all about calling the weak and sick from the population and doing things like I did I did an interview years ago for one of the science magazines where the interviewer, real nice woman, wanted me to make clear that as a Darwinian pediatrician, I was in favor of taking care of the weak and the sick also, you know, because she she thought Darwinism implied that, you know, some people might think that that's not the case. So, I mean, I think uh done done poorly, social Darwinism can can creep in. Um, evolutionary biologists, if you hang around in those circles, you'll often hear them say evolution is uh or the theory is descriptive, not prescriptive. And and it is it's it's up to you. But in a little sense in evolutionary medicine we we kind of violate that in the sense that we'll say things like uh we you know we we might prescribe letting that fever go because fever is an involved adaptation that helps you to uh fight your illness. So, so we're being I mean we're not forcing anybody's hand, but we're giving advice that says uh avoid the trans fats, uh let the fever go, let the you know those kinds of things. So, we're being a little bit prescriptive, I guess. I uh I have a friend who is very forward thinking around his health, early 30s guy, and he he actively seeks out illnesses that cause uh fever. And this is because of some evidence that he's looked at that suggests that uh getting a fever and raising your body temperature internally uh is um good at is protective against cancer growth because it it burns that through. Whereas you know immediately you have a uh you have a fever and what are you doing? I I'll regulate with air conditioning. I'll take something to bring down the temperature. I'll go in and see the doctor. So on and so forth. Yeah. It's it's funny the problems that are caused by being able to fix problems, you know. Right. Mhm. Right. No, you're right. Yep. Uh and and without recognizing that some of them are defenses, if it's normatively bad, feeling sick with a fever is normatively bad. And so doctors exist to fix things and make you feel better. And so we prescri we tell you to take you know the old saying not in pediatrics but the old saying for adults was take two aspirin and call me in the morning right uh and we don't give aspirin to kids but uh the the idea is the same we we we you know we often tell them take take your ibuprofen or your acetammenophen you'll feel better. Um and there are rules for those things. It's not like you can never use them, but uh uh it's yeah, like you said, uh fixing things often makes things worse. Paul Turk, ladies and gentlemen, Paul, you're awesome. Uh I think an evolutionary perspective on child rearing uh was desperately needed and I'm really glad that Rob introduced me to your work. I think I think it's so great. Where should people go? They're going to want to keep up to date with the stuff that you do and get a hold of the book. Uh yeah, I mean the book's available on on Amazon. It's called Bringing Up Baby, an evolutionary view of pediatrics. Uh they can go to my uh website. Uh anybody uh who wants to ask me a question about uh uh their child. They can they can uh call my office. Uh how amazing. Uh I I I I I'm always interested to talk to people about uh um evolution and child rearing. I I've had I I I'm fortunate to have so many wonderful parents in my practice who um sometimes I feel like I'm might be boring them with some explanation, but then then that they come back to me and they say, "Wow, that that's really cool." And I I ran into a woman in the grocery store the other day who read my book and she says, "I didn't know you were so funny. I I try to put a few jokes in there, you know, to keep people's interests and so on." So, so yeah. So, it's been exciting for me to write the book and to uh have people like you and Rob notice it. And I'm very grateful for being able to talk to you. I I I I been watching your podcast. My son has been a big fan for a long time. He Yep. Yep. And he's Yep. Well, I promise you that you haven't bored anyone today, Paul. And if you're uh if your son is a fan of the show, that suggests even more about the quality of the genetics. I'm uh I'm I'm very I'm very good. Uh I I really appreciate you, Paul. Until next time. Okay. Yeah. Well, thank you. Yeah. Okay. Take care. Congratulations. You made it to the end of the episode. And if you want more, well, why don't you press right here [Music]